(Health) 8 – Florida Laws and Rules Pertinent to Insurance

The Bureau of Unclaimed Property is overseen by the

Chief Financial Officer The Chief Financial Officer oversees the Bureau of Unclaimed Property.

An example of unfair discrimination would be

offering different terms of coverage for different policyowners having the same risk classification Providing different terms of coverage for different policyowners in the same risk classification would be an example of unfair discrimination.

A foreign insurance company doing business in Florida

is a company that was formed under the laws of another state In Florida, a foreign insurance company is a company that is formed under the laws of a state other than Florida.

An agent selling Medicare Supplement policies must provide every applicant with a(n)

Suitability form Every agent soliciting Medicare Supplements must provide a suitability form.

A person insured under a health policy is required to give the insurance company a Notice of Claim within how many days after a covered loss?

Twenty Written notice of a claim must be given to the insurer within 20 days.

How many hours of continuing education must a newly licensed agent complete every two years?

24 A newly licensed agent must complete 24 hours of continuing education every 2 years.

An insurance company incorporated under the laws of the state in which its home office is located is called a(n) ____ company.

domestic A domestic insurance company is domiciled and incorporated under the laws of the state in which its home office is located.

When is a Group Health policy required to provide coverage for a newborn child?

At the moment of birth A Group Health policy is required to provide coverage for a newborn child at the moment of birth.

A Multiple Employer Welfare Arrangement (MEWA) provides what type of benefits?

Insurance A Multiple Employer Welfare Arrangement (MEWA) provides insurance benefits.

What is the required minimum percentage of employee participation for a noncontributory group health insurance plan according to Florida Law?

0% Most noncontributory group health plans require 100% participation by eligible members. Under Florida law, there is no specific minimum percentage participation for employees covered by employee group health insurance.

What are adjustable rates for life policy loans in Florida based on?

Moody’s corporate bond index Adjustable rates for life insurance policy loans in Florida are based on Moody’s corporate bond index.

In Florida, most life insurance policies have a contestability period of

2 years The maximum contestability period for most life insurance policies is 2 years.

An example of an unfair trade practice is

an agent making a material misrepresentation to the insured Making a material misrepresentation to an insured is considered to be an unfair trade practice.

K is an agent who made an improper sale of an annuity to a client. Which of the following corrective actions would the Department of Financial Services likely order K to take?

Pay monetary restitution to the client The Department of Financial Services may order the agent to pay monetary restitution to the client.

Which of the following situations does NOT apply to the Florida Replacement Rule?

An existing policyholder purchases an additional policy from the same insurer Florida’s Replacement Rule applies to all of these situations EXCEPT "An existing policyholder purchases an additional policy from the same insurer".

Which two entities regulate variable annuities?

Department of Financial Services; and Securities Exchange Commission Variable annuities are regulated by both the Department of Financial Services and the Securities Exchange Commission.

According to Florida’s life insurance replacement laws, a policyowner must be provided with a written Comparison and Summary Statement when it’s requested by

the policyowner The replacement of existing life insurance policies with new contracts of life insurance requires a written Comparison and Summary Statement at the policyowner’s request.

All of the following are Nonforfeiture Options EXCEPT

Automatic Premium Loan Option An automatic premium loan is not considered a Nonforfeiture Option.

Group Life policies in Florida are required to contain a conversion privilege that allows for conversion

to an individual policy for a stated period of time In Florida, Group Life policies must contain a conversion privilege that allows for conversion to an individual policy for a specified period of time.

In Florida, monthly-premium health insurance policies must provide a grace period of at least

10 days In Florida, monthly-premium health insurance policies must provide a grace period of at least 10 days.

T is an employee covered under a Group Life policy. If T’s employment is terminated, the conversion privilege gives T the right to convert

to an individual policy upon employment termination When an employee covered on a Group Life policy leaves the group, the conversion privilege gives the employee the right to convert to an individual policy upon termination of employment.

Under Florida law, which of the following provisions is NOT required in a Medicare Supplement policy?

Limitation on pre-existing conditions for up to 12 months There is only a 6-month limitation on pre-existing conditions for Medicare Supplements.

What do families pay that are covered by the Florida Healthy Kids Corporation?

A portion of the premium Families with children covered by the Florida Healthy Kids Corporation program pay only a portion of the premium.

If a policyowner does not pay the premium by the due date, the

policyowner can make the premium payment during the grace period If a policyowner does not pay the premium by the due date, the premium may be paid during the grace period.

Which of the following employees may NOT be excluded from a group life plan?

Full-time employees after the probationary period All of these employees may be excluded from a group life plan except for "Full time employees after the probationary period".

In Florida, an insurer licensed to conduct business in Florida, but domiciled in New Jersey, is called a(n)

foreign company An insurance company that is domiciled in New Jersey and licensed to conduct business in Florida is referred to in Florida as a foreign company.

Florida’s 14-day free-look period for life insurance policies begins at the

date of delivery In Florida, the free-look period for life insurance contracts is 14 days from policy delivery.

Insurance companies that are organized in countries outside the United States are referred to as

alien An insurance company that is organized or chartered in a country other than the United States is defined as alien.

Florida requires that coverage for newborns begins "from the moment of birth" and continues for

18 months Florida requires that newborn coverage begins "from the moment of birth" and continues for eighteen (18) months.

Advertising gifts not to exceed ___ are allowed to be given by an agent to a prospective client.

$25 An agent is allowed to give advertising gifts to a prospective customer, provided they do not exceed $25.

When replacing or exchanging an annuity, the agent must disclose to the annuitant

the possible tax ramifications as a result of the transaction An agent must disclose the possible tax consequences of replacing or exchanging an existing annuity or life insurance policy.

In Florida, agents are allowed to engage in rebating if

offered to all insureds in the same actuarial class Rebating is allowed in Florida if the agent rebates insureds in the same actuarial class.

In Florida, when agents recommend changes be made for existing coverage, the agent must follow established procedures. The name of this rule is called the

Florida Replacement Rule The Florida Replacement Rule sets forth the requirements and procedures to be followed by insurance companies and producers when replacing existing life insurance contracts.

How can an agent-in-charge have more than one location?

Only if the agent-in-charge is present when insurance activity occurs Multiple locations are allowed as long as the agent-in-charge is present when insurance activity occurs.

In Florida, which of the following is considered an Unfair Trade Practice?

Coercion Coercion is considered an unfair trade practice under Florida law.

An example of an unfair claims practice would be

failing to effectuate prompt, fair, and equitable settlements of a claim Failing to effectuate prompt, fair, and equitable settlements of claims is considered to be an unfair claims practice.

Which Unfair Trade Practice involves making a false statement on an insurance application in order to receive money from an insurer?

Misrepresentation Making a fraudulent statement on an insurance application would be considered an act of misrepresentation.

Upon reaching the limiting age, a handicapped child can extend their health insurance coverage as a dependent

only if the child is incapable of employment and chiefly dependent on the policyowner Coverage may be extended if the handicapped child is incapable of employment and chiefly dependent on the policyowner.

Which action could result in a hearing being ordered by the Department of Financial Services?

Performing insurance transactions without a license A hearing may be conducted if anyone is suspected of engaging in the business of insurance without a license.

An agent who makes misleading statements that lead to the termination of an existing insurance policy so that a new policy with another insurer can be taken out has committed

twisting Twisting is knowingly making misleading statements that would cause an insured to lapse, assign, or terminate an insurance policy in order to switch companies.